![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 2874 to 2898 of 10407. Go back in thread:
Posted by jannbeau on November 15, 2002, at 10:48:37
In reply to re: prescription medication without a prescription » anais, posted by Dr. Bob on November 14, 2002, at 19:11:09
> >Hi, Dr. Bob:
The message about which you comment below states in the last sentence something to the effect that "your doc just faxes the prescription." If I read that post correctly AND if I have correctly interpreted the comments from the link you provided, this particular posting doesn't suggest an illegal action, since it clearly states that a prescription is needed. I didn't find anything in the notes at your link that I interpreted to mean that it is illegal to import a medication from Canada as long as one can produce a valid prescription. Have I misinterpreted something here?
Thanks and Cheers,
Jannbeaulook up a few websites via google.com...
>
> I understand you're trying to help, but please don't use this site to exchange information on how to import into the US prescription medication without a prescription:
>
> http://www.dr-bob.org/babble/faq.html#illegal
>
> Thanks,
>
> Bob
>
> PS: Follow-ups regarding posting policies should be redirected to Psycho-Babble Administration.
Posted by anais on November 15, 2002, at 11:27:55
In reply to Anyone had success on Effexor XR? , posted by jp on October 24, 1999, at 14:59:14
can different drugs' potencies be compared in milligrams? example- i used to take 30mg paxil/day, which was really not enough, but 40mg made me sleep @ 15hours/day! my lousy doctor told me to take 150 mg/day of effexor, but during the "rev up" period, i was feeling much better, read more about the drug, and decided to stay at 37 mg/day. i feel fine, except for awful insomnia. does anyone have that? so my question is- how do 30mg of paxil and 150mg of effexor compare? does it have the same potency? would that make paxil 5x stronger than effexor? does it have anything to do with toxicity (60mg/day paxil; 300mg/day effexor)? according to these posts, effexor seems incredibly strong. so why would the doc increase dosage by 120mg with a stronger drug than the first? is he really inept, or can milligrams just not be arbitrarily compared?
thanks!
ps- can anyone sleep all night on this stuff?
Posted by jannbeau on November 15, 2002, at 13:48:25
In reply to Re: Effexor, think twice!!!!, posted by harryartin on November 15, 2002, at 4:56:55
>Hi, Harry, you aren't going to believe this, but I don't know how to find your new thread! How do I get there?
Cheers,
JannbeauWell jannbeah, read my new thread, because all in all even though I feel well on effexor, I still feel drugged and that sucks! My motivation just isn't there! I'm just so afraid to go off this drug because of possible adverse reaction!
> Harry
Posted by jannbeau on November 15, 2002, at 13:48:44
In reply to Re: Effexor, think twice!!!!, posted by harryartin on November 15, 2002, at 4:56:55
>Hi, Harry, you aren't going to believe this, but I don't know how to find your new thread! How do I get there?
Cheers,
JannbeauWell jannbeah, read my new thread, because all in all even though I feel well on effexor, I still feel drugged and that sucks! My motivation just isn't there! I'm just so afraid to go off this drug because of possible adverse reaction!
> Harry
Posted by Kalevi on November 15, 2002, at 14:20:33
In reply to Re: Effexor, think twice!!!!uppdate, posted by jannbeau on November 13, 2002, at 16:02:12
Hello again :-)
Im on day 8 ... and counting days, it feels better for every day that goes by.
I tried cognitive-behavioral therapy for 2 periods a' 12 months. The first period gave me quite a lot and learned me that Im not a superhuman who must work for 70 hours a week and that no one's thanking me when i am ill. The second period was i total disaster with a new theraphist who couldnt learn my name or remember what we had been talking about on my last visit. She only managed to make me angry and frustraded and my therapy was about why I had such angry feelings against her and she also suggested angercontroltheraphi. Finally i fired her and suddenly my angercontrolproblem where gone ;-) I dont think Im so much in need of theraphy anylonger and the main cause to my depression where that i was sooo burned out and totally deathtired. Now my familly is calling for my attention so i have to break here and leave the next chapter for an other day.
Bye everyone and good luck and remember... use drugs as the last option.
YS
Kalevi> > Hi, Kalevi. It might take longer than 6 days to get over the discontinuation syndrome. It took me about three weeks to feel like myself again. I might add that one of things I had when I stopped was ANGER, lots of it, for a few weeks after stopping Effexor--at everyone and everything. The anger went away, too. Even my husband noticed those days and the change over a few weeks. You should get better. But, be aware, too, that you could slip back into a depression, also. If you do this, please seek help, ok?
>
> As another poster said, maybe a psychologist is a better therapist these days. There ARE alternatives to medication for depression. The alternatives have been around for longer than the meds. Have you gotten any psychotherapy? I might suggest cognitive-behavioral therapy. Why don't you look into this avenue?
>
> Hey, have you thought of this? Maybe it's evolution - or not, as the case may be, that is causing this seeming epidemic of depression, panic, borderline personality, bipolar dx? The rapid evolution of computers and the advent of global communications have caused our poor little primitive brains to go on the fritz; hence the term "burnout?" We are drowning under the pressures placed upon our nervous systems from these technologies, I am convinced. It will take eons for the human brain to catch up with today's technology, unless you believe in Lamarckian (sp?) evolution--I don't. Or, more simply, maybe it's the drug companies and their shareholders! Or the psychiatrists who are too lazy, too busy, or too uninformed to try anything other than drugs. As another poster said, maybe a psychologist is a better therapist these days. There ARE alternatives to medication for depression. The alternatives have been around for longer than the meds. Have you had any psychotherapy? I might suggest cognitive-behavioral therapy. Why don't you look into this avenue?
>
>
> With regard to "taking care of each other:" that's what this board is for (even if it is made possible by the very thing that has created the problem--ironic, is it not?)!
>
>
> Jannbeau
> I'm on day 6 without my effexor and still have problems as the one disciribed in my post but It feels easier and the dizziness has stopped so now i can at least keep the food. I'm so angry at my doctor for not letting me know the side-effects of effexor and when I read the manufacturers page, none of my problems are discribed there or any warnings at all about how hard it is to get off this drug. I am lucky that im in god medical and psykic health now, otherwise i dont know what i had done to my self. My hope is that people think twice befor taking medication like prozak, effexor and it really disturbs me that there is no alternative threatments for depression. My brother told me that deep in the forrests in finland people cure their depression with a god hangover and a sauna ;-) and after that they go fishing for a week... Maybe thats the miraclecure for depressions that scientists have been looking for.. 3-4 hours hangover, sauna and fishing instead of years of medication and terrible side effects.
> >
> > Im better make my self clear... I am alive to day thanks to effexor... but i still have many doubts about medication against depressions. People have had depressions since stonehedge and never had to use drugs like prozak and effexor. Whats the deferense between to days humans and our forfathers... Have we forgotten how to take care of each other and what miracles love and empati can do. I really wish people to use drugs as the absolutely last option and not taking easy on adding this chemikals to your system. Im shure that If my lifesituation during the time i got ill had been better and i would had the opportunity to take some time of on the contryside I could had been back as a functional person after maybe a few months instead of drowning under depression and medication for 3 years..
> >
> > /Kalevi
>
>
Posted by JayM on November 15, 2002, at 15:14:04
In reply to Anyone had success on Effexor XR? , posted by jp on October 24, 1999, at 14:59:14
I'm due to start on Zoloft or Effexor soon. Anyone care to compare the two meds or relate your experiences with both meds?
Posted by jenni.39 on November 15, 2002, at 18:31:47
In reply to Re: Effexor - withdrawal update » dot, posted by Reneeb on March 7, 2002, at 15:21:40
> > > > > Hi Dot, I thought effexor worked great until I noticed I gained 10 pounds. We were all told that effexor didn't put weight on you??? I am also on wellbutrin and I like that a lot seems to give me more energy. I went back on my dose of 37.5 and when I see my doc on friday I am going to ask him if he could put me on something else so the withdrawals aren't so bad. I have read many post where people were successful doing it this way. Let me know what you doc says I will be interested to hear what advice he gives you.
> > >
> > > Take Care,
> > >
> > > Renee
> >
> > i didn't notice any weight gain with effexor, if anything i lost a bit of weight since i didn't really feel as hungry anymore. i was worried it would make me lose a lot of weight since that is what happened when i tried prozac. i stopped eating for over a month before i had to stop taking it.
> > i think trying another med to help you ease off the effexor is a good idea. i am feeling ok now but wouldn't recommend cold turkey to my worst enemy. i stopped taking the dramamine today to see how i felt and i was ok, just a bit dizzy but it isn't interfering with work and i feel like i could drive a car now.
> > i told the doctor that i was going to wait a few weeks to decide if i was going to start another med. the idea of having a sex life again is pretty tempting so i might just try to go without anything and see if i get depressed again...
> > i'll keep you posted on futher developments.
> > thanx, dot
>
>
>
> Hi Dot, Since I have lowered my dose of effexor and use a higher dose of wellbutrin, my sexual drive has gone crazy!! I love it...LOL
>
>
> Renee
i have a friend who lost loads of weight after starting Effexor, i haven't noticed this affect on me(sadly)...tho she lost her sex drive too and i found mine enhanced....
Posted by Dr. Bob on November 16, 2002, at 0:23:05
In reply to re: prescription medication without a prescription » Dr. Bob, posted by jannbeau on November 15, 2002, at 10:48:37
> > look up a few websites via google.com...
> The message about which you comment ... states in the last sentence something to the effect that "your doc just faxes the prescription."
Yes, but her original search instructions led to sites that did *not* require them.
Bob
Posted by Sioux on November 16, 2002, at 0:56:10
In reply to re: prescription medication without a prescription » Dr. Bob, posted by jannbeau on November 15, 2002, at 10:48:37
Hello to you, too, Dr Bob.
I have to add here that the idea of buying drugs illegally or without a prescription online never even occurred to me until you mentioned it.
All of my meds - except the i.v. infusion - come online anyway at the behest of my insurance. I am pleased to have a way to responsibly research for prices for those *many* times when the insurance has screwed up.
> > >Hi, Dr. Bob:
>
> The message about which you comment below states in the last sentence something to the effect that "your doc just faxes the prescription."
Posted by Caro on November 16, 2002, at 1:14:19
In reply to Re: Low dose effectiveness, posted by jannbeau on November 13, 2002, at 15:04:58
I've been taking 25 mg of Effexor for the past 3 years or so, and have been happier, more positive, and less guilt-ridden than I ever have been in my depressive life. Couldn't take a higher dose anyway as I started confusing vivid dreams with real memories at 50 mg.
However, I am starting a VERY slow withdrawal to see if that helps my urinary urge incontinence, which started soon after starting effexor, and has recently worsened. My doctor DID warn me of the need to withdraw slowly, and I'm starting with twice a week of 3/4 of my regular dose, and the regular dose the other 5 days. In two or three weeks, I'll do a similar small decrease. Hope it will work to avoid avoid the horrendous withdrawal stories I've seen here.
(I had tried a similar decrease in the past, but depressive symptoms returned and I went back to my usual dose.)
On another issue, have any of you had much success with SAMe? A friend of mine has done very well.
Posted by japonica on November 18, 2002, at 12:39:22
In reply to Re: Anyone had success on Effexor XR? , posted by JayM on November 15, 2002, at 15:14:04
Hello JayM,
Please bear in mind that the following is my own personal experience as you requested. I am neither condoning nor advising against either med for your own use.
I have tried both meds. Zoloft was first. I was on it for 8 weeks this spring and summer. While on Zoloft I felt fuzzy and confused most of the time. My depression DID lift for the most part but I gained 25 pounds almost instantly.I quit Zoloft cold turkey with no noticeable side effects.
I've now been on Effexor XR for 6 weeks. I am only at 75mg. I feel very alert, can sleep well, am very focused at work, and I'm finding enjoyment on all the little things I used to enjoy. I'm looking forward to the holidays more than I have in several years. I have lost all the I gained on Zoloft.
I have been on several other meds in my search for relief from my depression. You can find all the gory details in my post on Nov 7, 2002. Subject:Effexor Newbie.
Good luck to you! Keep us posted on your progress.
japonica
Posted by wheresheruns on November 18, 2002, at 14:42:31
In reply to Bruising and Effexor Withdrawal, posted by WhereSheRuns on June 23, 2002, at 2:06:06
I was on effexor xr for 3 mnths. I had severe bruising from little things like lightly bumping into tables, etc. So my doc did a little research, contacting the company that makes effexor, and found out this.. One in a hundred people experience the bruising. It's not because the effexor depletes the blood plateletts, but it mutates and damages them. According to the company and my own experience, the bruising should stop after about 3 months after you stop the effexor xr. Another strange thing.. Im now trying effexor again, but not xr.. No bruising so far..
Posted by bridgette_31 on November 18, 2002, at 14:58:00
In reply to Re: Have I got too many side-effects?, posted by Noorah on October 22, 2002, at 10:05:38
I started Effexor 2 weeks ago and I feel great! I haven't experienced any nausea, I make sure to take it on a full stomach. I had horrible jaw grinding with Celexa and I only have it slightly with Effexor. I do feel a little sleepy, but I am willing to ride it out because my anxiety and agressive feelings have calmed quite a bit. I hope your symptoms like with most new drugs will subside after a few weeks. I know that I feel better just after 2 weeks and the sleepiness I can deal with.
Posted by bridgette_31 on November 18, 2002, at 15:01:36
In reply to Effexor XR and ADD/ADHD?, posted by Lost Lamb on October 22, 2002, at 1:32:08
Both of my children have been diagnosed ADHD and take Adderall. An ADHD person's reaction to stimulants is the opposite of a person who is not AdHD. Giving an ADHD person an antidepressant for instance would actually increase depression. A stimulant for them actually is calming. I can't imagine an ADHD person being given antidepressants!! I give my kids caffeine and they take a nap.
Posted by jannbeau on November 18, 2002, at 19:09:53
In reply to Re: Effexor XR and ADD/ADHD?, posted by bridgette_31 on November 18, 2002, at 15:01:36
>Bridgette, could be, but I am not predisposed to make or to accept sweeping generalizations about any illness or any medication. Peoples' illnesses and their reactions to psychoactive medications may be far too complex for these kinds of statements.
Everyone, please seek competent professional advice before you take any medication or before you reject the option.
Cheers,
Jannbeau
Both of my children have been diagnosed ADHD and take Adderall. An ADHD person's reaction to stimulants is the opposite of a person who is not AdHD. Giving an ADHD person an antidepressant for instance would actually increase depression. A stimulant for them actually is calming. I can't imagine an ADHD person being given antidepressants!! I give my kids caffeine and they take a nap.
Posted by dde on November 18, 2002, at 19:40:41
In reply to Re: Effexor XR and ADD/ADHD?, posted by bridgette_31 on November 18, 2002, at 15:01:36
So, yet another parent who questions the use of an anti-depressant for the use on ADHD. Our experience was just as you say: giving him more and more of the effexor xr increased his depression, so much so that he took his life. Some major research needs to be done before they start just handing this stuff out to kids who are ADHD, kids with ADHD and symptoms of depression and ADHD and kids who are bi-polar. This would require some one on one time with the doctor, which my son had only 10 minutes of. Please, people, make sure the doctor REALLY KNOWS the child before putting them on numerous medications. The child's life could be at stake. Please forgive my grieving, I am moving into the angry stage, and it may appear that I am anti doctor. That is not the case, I just think the doctor should have spent more time getting to know my son before arbitrarily prescribing medication and never following up on him, but allowing his nurse to do the followups! This nurse actually had the gall to tell me that their clinic had done extensive research on children and found it to be best for kids with ADHD! She never even addressed the depression that we went there to address! Best regards, dde
> Both of my children have been diagnosed ADHD and take Adderall. An ADHD person's reaction to stimulants is the opposite of a person who is not AdHD. Giving an ADHD person an antidepressant for instance would actually increase depression. A stimulant for them actually is calming. I can't imagine an ADHD person being given antidepressants!! I give my kids caffeine and they take a nap.
Posted by Stamper on November 19, 2002, at 9:40:11
In reply to Re: Have I got too many side-effects?, posted by bridgette_31 on November 18, 2002, at 14:58:00
Has anyone experienced a metal taste in their mouth? Also muscle twitching and jerking which seems to be worse at night? Most of my other side effects have gone away but these remain and are most annoying. My psych said the twitching is rare. I have had these side effects since starting effexor xr and wellbutrin sr about April.
Posted by SJMA on November 19, 2002, at 14:09:27
In reply to Re: Have I got too many side-effects?, posted by Stamper on November 19, 2002, at 9:40:11
> Has anyone experienced a metal taste in their mouth? Also muscle twitching and jerking which seems to be worse at night? Most of my other side effects have gone away but these remain and are most annoying. My psych said the twitching is rare. I have had these side effects since starting effexor xr and wellbutrin sr about April.
>
I have started to have an intermittent hiccup. Just every once in a while, I hiccup. Not numerous times, like when you have to drink water and stand on your head and such, just a single hiccup. Anyone else noticed this?
Posted by wheresheruns on November 19, 2002, at 20:28:14
In reply to Re: I gained 20 pounds BLAH, posted by Angel1 on September 3, 2002, at 15:15:55
It seems like skinny people who are on effexor gain weight and the not so skinny people lose weight. I lost 20 lbs while I was on effexor xr (I weighed in @ 150 at 5'9", and when I came off of it I was at 130). I was on it for 3 months and and Ive now been off of it for about 5 months. Since then I've only gained back 5 lbs. I think it permanently changed my metabolism, because I don't watch what I eat.
It would be great to hear about some weight gain/loss issues from others out there on effexor or any other drug for that matter =)
Posted by sly on November 22, 2002, at 9:02:24
In reply to Re: I gained 20 pounds BLAH, posted by wheresheruns on November 19, 2002, at 20:28:14
When I started Effexor I was about 5'5 and 130, I lost 20 lbs in the first 3 months, however I still felt very depressed. I had anhedonia, total loss of pleasure which included eating, but I was also bingeing at the time. It all turned around after 4-5 months, the depression began to lift and I started to gain some weight back.
I try not to weigh myself anymore, but I know I haven't put it all back on because my old clothes are still a little too big.
Posted by Zinya on November 22, 2002, at 14:48:01
In reply to Re: Effexor dose--lowering it? Cam-anyone? » shar, posted by Cam W. on August 10, 2000, at 1:26:15
I'm working my way through these posts for the first time and still in posts from 2 yrs ago so I don't know yet who is still on here or not, but now find myself with a Q to post before I forget it ...
Both Cam and i think Kimberley have talked about how the multiple effects of Effexor kick in at different dosages -- that at lower doses it's more of a serotonin effect, higher levels bring on noreneprine effects, the highest leves add dopamine effect. Does anyone know if these vary by individual? Or is it possible to 'quantify' at what levels these additive effects take place? The posts I'm reading here imply that at 225mg, people are at more of (or equal effects on?) noreprenephron levels and advising people who are going off that at some point they will re-enter a 'serotonin-only' effect stage... Does anyone know what level that distinction happens at (for someone going on the way up or down in dosage levels?) Specifically, at 150 mg, can one expect to already be gaining both effects or is that still more of a serotonin effect level?
fyi: I have tried either an AD (prozac) or a bipolar med (lithium, and one other - i think it was depakote) about 4 times scattered over past 15 yrs each time (except once) giving it at least a month but the combo of side effects and failure to feel any decrease in depression led me to quit. Not coincidentally, I think, that time frame coincided with both grief (my dad's death 15 yrs ago) and diagnosis of fibromyalgia/chronic fatigue syndrome at that same time 15 yrs ago with lesser and greater struggles with the latter even since. Now as of 3-1/2 months ago, my mom has passed away after my taking care of her (alzheimer's) for 8 years, at the end moving her to live with me, buying home in order to do so, only to discover that she had an undiagnosed cancer and that enormous output whereby as recently as 10 months ago, i was cooking on 5 burners at once in the process of escrow, moving her and me, with expectation of having several years yet with her. I would say 80% of my identity became caring for her, happily so, as she was very precious to me. The sudden loss has been fairly devastating, and I increasingly realize as much to my own sense of self (purpose, future direction, resume career i'd put on hold to care for her, etc.) as the grief and loss itself... This led me to feel that I by now perhaps this was more depression I'm dealing with than guilt per se, and so went to my md. yesterday who I hadn't seen in over a year -- an md. who had been previously helpful in suggesting new paths for dealing with a hormonal imbalance. But I went to him already saying I thought it was time to try an AD if there was now a new one and a different one I hadn't already tried. I'd heard of Lexapro and also Paxil CR, neither of which i'd tried. He said Lexapro was so new he'd had no experience with it, that Paxil CR might be okay, but proposed Effexor XR instead, telling me only that it works on both serotonin and norepinephrine (adrenalin levels, right?) too--which sounded good since I've long felt my adrenalin levels were erratic and mostly unreliably low [and actually tested low once 2 yrs ago]. He said nothing about how different levels of the Effexor yield different mixes of effects and so I assumed it would work on both equally from the outset. (He also said nothing about dopamine levels that two of you have mentioned -- and I don't know what that does to one's system except one of you mentioned that it offsets serotonin effects -- which sounds odd as to why a drug would have one thing offsetting another) ...
Since I'd never heard of Effexor, I decided to check out the web last night before starting it today and stumbled on this site first of all. I've read just enough already that I've postponed starting it until I read all these posts and other websites first.
I had allowed myself, I now realize, to sort of "forget" the realities of side effects -- last time I tried any such AD was 2 yrs ago briefly Celexa than an endocrinologist thought would be the ticket for me and I couldn't tolerate it (as I recall I became agitated, but i could be forgetting the specific side effect) and that was a case of not even making it to a month's worth on the drug...
I've added this background of my own situation in case it helps to know where I'm coming from in asking this question about dosage levels and effects... Again, I haven't started yet. What he gave me was 37.5 to take for 1 week, then 75 mg to take for 3 wks with the idea that I would then go to 150 mg if okay a month from now on the lesser dosages. I'm partly wondering, after reading these posts so far, if for the first month, not yet up to 150, will I only be getting the serotonin effects? One person spoke of having superordinate energy levels in first month (which sounds wonderful to me if it didn't mean agitatedly so -- my single biggest manifestation of depression is zero energy to do much of anything -- a 180 degree contrast looking back to where I was just 10 months ago.... or even 4 months ago in the throes of being nurse 24/7 to my mom etc... Even my doc and a bereavement counselor I have seen suggest and recognize that the grief process itself could be much or most of this zero-energy but since it seems to have gotten worse instead of easing up--and since a prior history makes me think that this grieving is not an isolated phase but bringing to bear full force a predisposition that was already there but somehow more often masked than unmasked, that was why I began to feel a need to try an anti-dep but now I'm reminding myself from reading here that the concern with side effects possibly making this grief period actually worse instead of better... Of course, I'll never know if I dont' try, but I am trying to avoid making too hasty a decision here and wondering if I should postpone trying an AD again to see. And yet holiday season looms as a time that always was a rough time even when I had energy.)
Well, enough babbling/background. If anyone has advice, answers, thoughts on any of this, I will greatly appreciate it... Meanwhile, I'll keep reading your postings up to the present...
Thanks.
Posted by jannbeau on November 22, 2002, at 16:43:10
In reply to Re: Effexor dose levels and effects? Cam? anyone?, posted by Zinya on November 22, 2002, at 14:48:01
> Hello, Zinya and Welcome to Psychobabble-Effexor! My name is Jannbeau and I occasionally post my thoughts here--my own opinions, only, as I am not a doctor, so take my comments for what they are worth, which might not be much!
Please accept my deepest sympathy for you upon the loss of your dear mother. My mother died almost ten years ago and I have yet to recover fully, so don't be surprised if this takes you a long time. The loss of one's mother is devastating to any person, man or woman, I think. I know that we are supposed to be healthier if we can let go, but. . .I loved her so!
Then, also, please let me say up front that I am not a doctor so I cannot tell you how to treat your illness.
With respect to your questions about Effexor, I would suggest that the approach you are attempting may be too analytical. Most of the effects about which you comment are those observed in experimental animal or cell culture experiments on receptor kinetics. It is difficult, if not impossible, to sort these effects out in the human brain because, generally, we cannot do the experiments; although there are some noninvasive imaging techniques that will give a good idea of what areas of the brain are more or less active under different conditions, including those of depression, agitation, personality disorders, and drug therapy, these are seldom definitive of the neurotransmitter systems in operation. There are too many of them and they are too intertwined to make these simplistic statements about the activities of such systems at different doses of a medication(by the way, norepinephrine is NOT adrenalin, it is noradrenalin, a related compound; adrenalin is also known as epinephrine). Additionally, there are multiple neuromodulators in the brain, including triiodothyronine, substance P, etc, just to mention a couple (I don't keep up too well with the research anymore) that modify the behavior of neurotransmitters on brain function AND that may affect the efficacy of a medication for a given disorder in a given individual. Which brings me to the question of interindividual variability in response parameters: each person probably has a different threshold in his/her brain for different effects of a dose of any given medication, meaning that my brain might react differently to a certain dose of a medication than would your brain. Sometimes one medication will not even work on a specific person, although it works fine for another. All we can talk about is the general effects of the medication, which in the case of the antidepressants is a lifting of depression.
Hope I've made my point without being didactic.God Bless and Good Luck. Let us hear from you with any concerns you might have.
Jannbeau
I'm working my way through these posts for the first time and still in posts from 2 yrs ago so I don't know yet who is still on here or not, but now find myself with a Q to post before I forget it ...
>
> Both Cam and i think Kimberley have talked about how the multiple effects of Effexor kick in at different dosages -- that at lower doses it's more of a serotonin effect, higher levels bring on noreneprine effects, the highest leves add dopamine effect. Does anyone know if these vary by individual? Or is it possible to 'quantify' at what levels these additive effects take place? The posts I'm reading here imply that at 225mg, people are at more of (or equal effects on?) noreprenephron levels and advising people who are going off that at some point they will re-enter a 'serotonin-only' effect stage... Does anyone know what level that distinction happens at (for someone going on the way up or down in dosage levels?) Specifically, at 150 mg, can one expect to already be gaining both effects or is that still more of a serotonin effect level?
>
> fyi: I have tried either an AD (prozac) or a bipolar med (lithium, and one other - i think it was depakote) about 4 times scattered over past 15 yrs each time (except once) giving it at least a month but the combo of side effects and failure to feel any decrease in depression led me to quit. Not coincidentally, I think, that time frame coincided with both grief (my dad's death 15 yrs ago) and diagnosis of fibromyalgia/chronic fatigue syndrome at that same time 15 yrs ago with lesser and greater struggles with the latter even since. Now as of 3-1/2 months ago, my mom has passed away after my taking care of her (alzheimer's) for 8 years, at the end moving her to live with me, buying home in order to do so, only to discover that she had an undiagnosed cancer and that enormous output whereby as recently as 10 months ago, i was cooking on 5 burners at once in the process of escrow, moving her and me, with expectation of having several years yet with her. I would say 80% of my identity became caring for her, happily so, as she was very precious to me. The sudden loss has been fairly devastating, and I increasingly realize as much to my own sense of self (purpose, future direction, resume career i'd put on hold to care for her, etc.) as the grief and loss itself... This led me to feel that I by now perhaps this was more depression I'm dealing with than guilt per se, and so went to my md. yesterday who I hadn't seen in over a year -- an md. who had been previously helpful in suggesting new paths for dealing with a hormonal imbalance. But I went to him already saying I thought it was time to try an AD if there was now a new one and a different one I hadn't already tried. I'd heard of Lexapro and also Paxil CR, neither of which i'd tried. He said Lexapro was so new he'd had no experience with it, that Paxil CR might be okay, but proposed Effexor XR instead, telling me only that it works on both serotonin and norepinephrine (adrenalin levels, right?) too--which sounded good since I've long felt my adrenalin levels were erratic and mostly unreliably low [and actually tested low once 2 yrs ago]. He said nothing about how different levels of the Effexor yield different mixes of effects and so I assumed it would work on both equally from the outset. (He also said nothing about dopamine levels that two of you have mentioned -- and I don't know what that does to one's system except one of you mentioned that it offsets serotonin effects -- which sounds odd as to why a drug would have one thing offsetting another) ...
>
> Since I'd never heard of Effexor, I decided to check out the web last night before starting it today and stumbled on this site first of all. I've read just enough already that I've postponed starting it until I read all these posts and other websites first.
>
> I had allowed myself, I now realize, to sort of "forget" the realities of side effects -- last time I tried any such AD was 2 yrs ago briefly Celexa than an endocrinologist thought would be the ticket for me and I couldn't tolerate it (as I recall I became agitated, but i could be forgetting the specific side effect) and that was a case of not even making it to a month's worth on the drug...
>
> I've added this background of my own situation in case it helps to know where I'm coming from in asking this question about dosage levels and effects... Again, I haven't started yet. What he gave me was 37.5 to take for 1 week, then 75 mg to take for 3 wks with the idea that I would then go to 150 mg if okay a month from now on the lesser dosages. I'm partly wondering, after reading these posts so far, if for the first month, not yet up to 150, will I only be getting the serotonin effects? One person spoke of having superordinate energy levels in first month (which sounds wonderful to me if it didn't mean agitatedly so -- my single biggest manifestation of depression is zero energy to do much of anything -- a 180 degree contrast looking back to where I was just 10 months ago.... or even 4 months ago in the throes of being nurse 24/7 to my mom etc... Even my doc and a bereavement counselor I have seen suggest and recognize that the grief process itself could be much or most of this zero-energy but since it seems to have gotten worse instead of easing up--and since a prior history makes me think that this grieving is not an isolated phase but bringing to bear full force a predisposition that was already there but somehow more often masked than unmasked, that was why I began to feel a need to try an anti-dep but now I'm reminding myself from reading here that the concern with side effects possibly making this grief period actually worse instead of better... Of course, I'll never know if I dont' try, but I am trying to avoid making too hasty a decision here and wondering if I should postpone trying an AD again to see. And yet holiday season looms as a time that always was a rough time even when I had energy.)
>
> Well, enough babbling/background. If anyone has advice, answers, thoughts on any of this, I will greatly appreciate it... Meanwhile, I'll keep reading your postings up to the present...
> Thanks.
Posted by zinya on November 22, 2002, at 18:19:08
In reply to Re: Effexor dose levels and effects? Cam? anyone? » Zinya, posted by jannbeau on November 22, 2002, at 16:43:10
hi Jannbeau,
first, thanks much for responding... and I appreciate your empathies... Indeed losing a parent and especially a mom and especially one you've taken care of is rough going... and I do realize it's bound to take time but knowing how to sort that out from some depression syndrome that needs treatment beyond that of time ... when I keep lagging in energy to do much of anything or even desire to do much except somehow in some abstract plane... I don't want to react too impulsively or desperately to get on a track with side effects (which previous a-d use unfortuantely involved) and withdrawal problems (which I don't think i *have* had in the past though) ... So i'm at least giving myself a few more days of reading here before deciding to 'take the plunge' ... Yesterday I came home from md. with the meds feeling only hopeful, but I *am* grateful something made me check the web first last night and realize I needed to think a bit more first about what might lie ahead ... And, in that regard, a new question: I realized last weekend (my body "speaking to me") that i'd surely overdone in past 3 months on alcohol - never very much but just that fact of having a glass of wine or the equiv. almost every night to the point that i realized i had to quit -- and this is the 5th day since last drop of alcohol, which seems at the least like a wise thing to do first and for a bit longer to try to detox my liver, if nothing else, before some new potency starts its effects ... And maybe in the interim some degree of depression might lift as well and alter how I weigh the cost/benefit of starting on this course... I must say the reports of withdrawal symptoms I started reading here were a big factor in taking a big gulp and thinking maybe wise to wait at least a while and keep trying to 'detox' in the interim... Do you know much about liver effects on Effexor?
One other Q - a clarification: You wrote that ".... they are too intertwined to make these simplistic statements about the activities of such systems at different doses of a medication(by the way, norepinephrine is NOT adrenalin, it is noradrenalin, a related compound; adrenalin is also known as epinephrine)"
I confess to just mimicking what i've heard without necessarily understanding it. Do you mean that the norepinephrine effects of Effexor do *not* work on the adrenal system? If you (or anyone) could elaborate any more on this, to the extent you could, I'd appreciate it ...
And, secondly, did you mean that the posters I'd read here who said the lower doses of Effexor impact more on serotonin and that they only start impacting norepinephrine at higher levels were speaking too simplistically? or incorrectly?
thanks again for your feedback and kind thoughts!
Posted by dde on November 22, 2002, at 22:25:58
In reply to Re: Effexor dose levels and effects? Cam? anyone?, posted by zinya on November 22, 2002, at 18:19:08
First, my heartfelt condolences.
Second, give yourself time to grieve. I have also lost a loved one, but to depression and Effexor XR. Please do not put a time limit on your grief or try to mask it with medication. It would be my opinion that trying to mask the pain, or the other effects such as no energy and loss of feeling, will only prolong the effects, as I have been told that once you come off the medication the feelings are still there and still have to be felt to get past them. After the death of my son in August, I took some Paxil for the anxiety. I can tell you that I became totally numb to any emotion, and that once I stopped taking it, I was feeling again, sometimes to an extreme, but at least I know it will come and go....not so with the medication....all I felt with it was NOTHING. Allow yourself all the emotion. It is natural and normal. Pain, Guilt, Anger (and this is the worst phase for me, so far, as when I am angry I cry, then become frustrated and cry more), will eventually turn to acceptance and being able to move on. Try to find a group for support. I have had to do that. I try to be kind with myself. The doctors keep trying to get me to take more medication as I have a heart condition and they are afraid of the stress of grief on my heart. I function at work, but on my off days, I find little to get out of bed for....some days I just stay there and FEEL.
I am told by our grief counselor that grieving has no time limit and takes different routes for everyone. I truly believe it is so.I hope you will give yourself time: time to feel and time to heal. If the healing doesn't start, if you aren't moving through the emotions, THEN look for the least offensive drug and listen to your body. I will keep you in my prayers. de
Posted by befree on November 22, 2002, at 22:29:40
In reply to Re: Anyone had success on Effexor XR? » Redula, posted by jannbeau on September 24, 2002, at 16:35:15
I took Effexor XR for two weeks and decided to go off of it because I was experiencing severe sleepiness and felt real spacey. I went off the medicine abruptly and didn't think that I would experience very many side effects because I was only on it for such a short while. Three days after withdrawing from the medicine I am experiencing bad lower abdominal cramping type pain, and dizziness? Is this normal? Any body else experience anything like this? If so, how long did it last?
Go forward in thread:
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.